Add your details

First name

Last name

Address

Do you have a formal or informal diagnosis of ADHD? If yes who by and when?

Who is your GP and Surgery details

DOB

Relevant physical medical history - conditions, disabilities ect

Mental Health History - Diagnoses, Medications, Self-diagnoses (anything that will help us understand how we can help you better)

Are you under the care of a CPN, SW, CMHT,

What do you struggle with the most in your day to day life which you put down to ADHD?

Please add the date you recieved your invitation to book this workshop

Have you already had a telephone referral taken by the Safe Space Team?

yes

Do you consent to us contacting you about future ADHD services?

yes

Are there any additional workshops you would be interested in doing? Please tell us

Make sure to visit our new website which has loads of update information

Want to add a comment?

Have you previously been offered an ADHD & Me workshop?

yes

ADHD & Me September 5th & 6th 2026

05 Sept 2026, 09:30 – 06 Sept 2026, 16:30Crumlin